US10172672B2 - Jaw force control for electrosurgical forceps - Google Patents

Abstract

A surgical instrument includes a first shaft, a second shaft, and a hinge. The first shaft includes a proximal handle and a distal jaw member. The second shaft includes a first segment that has a proximal handle and a second segment that has a distal jaw member. One of the first and second shafts is pivotal relative to the other to pivot the jaw members between an open configuration where the jaw members are spaced relative to one another and an activatable configuration where the jaw members are closer to one another and suitable for applying electrosurgical energy to tissue disposed therebetween. The hinge couples the first and second segments to one another. The first and second segments have a straight configuration where the first and second segments align with a longitudinal axis and a pivoted configuration where the second segment is disposed at an angle relative to the longitudinal axis.

Description

BACKGROUND

1. Technical Field

The present disclosure relates to electrosurgical forceps and more particularly, to a jaw force control for use with an open bipolar and/or monopolar electrosurgical forceps for sealing, cutting, and/or coagulating tissue.

2. Discussion of Related Art

Electrosurgical forceps utilize both mechanical clamping action and electrical energy to affect hemostasis by heating the tissue and blood vessels to coagulate, cauterize, and/or seal tissue. Electrosurgical forceps may be open forceps for use during open surgical procedures or may be endoscopic forceps for remotely accessing organs through smaller, puncture-like incisions during minimally invasive surgical procedures.

Many surgical procedures require cutting or ligating blood vessels or vascular tissue. By utilizing an electrosurgical forceps, a surgeon can cauterize, coagulate/desiccate, and/or simply reduce or slow bleeding simply by controlling the intensity, frequency, and duration of the electrosurgical energy applied by the jaw members to tissue.

In order to effectively seal vessels (or tissue) at least one of two predominant mechanical parameters must be accurately controlled—the pressure applied to the tissue (vessel) and the gap distance between the electrodes—both of which are affected by the thickness of the tissue before, during, and after sealing. It can be difficult for surgeons to control the pressure between jaw members before and during energy application.

SUMMARY

The present disclosure relates to a surgical instrument that controls the pressure applied to tissue between two jaw members by limiting a closure force of the jaw members. The surgical instrument includes first and second shafts that are pivotal relative to one another to move the jaw members towards a closed configuration. One of the shafts includes a first segment and a second segment that are pivotal relative to one another about a hinge. When the closure force of the jaw members exceeds a predetermined closure force limit, the first segment pivots about the hinge relative to the second segment to prevent the closure force of the jaw members from exceeding the predetermined closure force limit. The hinge may include a resilient member that exerts a closure force to the jaw members when the first segment is pivoted relative to the second segment.

In an aspect of the present disclosure, a surgical instrument includes a first shaft, a second shaft, and a hinge. The first shaft includes a proximal handle and a distal jaw member. The second shaft includes a first segment that has a proximal handle and a second segment that has a distal jaw member. One of the first and second shafts is pivotal relative to the other to pivot the jaw members between an opening configuration where the jaw members are spaced relative to one another and an activatable configuration where the jaw members are closer to one another and suitable for applying electrosurgical energy to tissue disposed therebetween. The hinge couples the first and second segments of the second shaft to one another. The first and second segments have a straight configuration where the first and second segments align with a longitudinal axis that is defined through the second shaft and a pivoted configuration where the second segment is disposed at an angle relative to the longitudinal axis.

In aspects, the hinge biases the first and second segments towards the straight configuration. The first segment may pivot relative to the second segment when a closure force of the jaw members exceeds a threshold closure force. The threshold closure force may be equal to or less than a predetermined closure force limit.

In some aspects, the hinge includes a fastener. The first segment may include a distally extending first flange that defines a first opening that is disposed over or receives the fastener therethrough. The second segment may include a proximally extending second flange that defines a second opening that is disposed over or receives the fastener therethrough.

In certain aspects, the hinge includes a resilient member that is disposed about the fastener between the first and second flanges. The resilient member may be a torsion spring. The resilient member may have a constant or progressive spring rate. The first and second flanges may each define a slot that receives a respective arm of the resilient member. The second flange may define a boss that extends towards the first flange. The boss may define a passage that is coaxial with the second opening and has a diameter that is larger than the second opening. The body of the resilient member may be received within the passage of the boss.

In particular aspects, the first shaft includes a stop that extends from an inner surface of the handle of the first shaft towards the handle of the second shaft. The stop may be configured to prevent the second shaft from pivoting beyond a closed configuration. The second shaft may include a lock that extends from an inner surface of the handle of the second shaft towards the handle of the first shaft. The stop may define an opening and the lock may include a detent that is configured to engage the opening to prevent the second shaft from pivoting towards the open configuration.

In another aspect of the present closure, a method of limiting closure force while grasping tissue with a surgical instrument includes positioning tissue between jaw members of the surgical instrument, moving handles of the first and second shafts of the surgical instrument towards one another to pivot the jaw members towards a closed configuration to apply pressure to tissue disposed between the jaw members, and limiting the pressure to a pressure limit by allowing a first segment of the second shaft to pivot about a common hinge relative to a second segment of the second shaft if the closure pressure exceeds a predetermined pressure limit.

In aspects, the method includes delivering electrosurgical energy with the jaw members to the tissue between the jaw members when the first segment is pivoted relative to the second segment. The method may include abutting a stop of the first shaft with the handle of the second shaft. Additionally or alternatively, the method may include locking the handle of the second shaft to a stop of the first shaft by engaging an opening defined by the stop with a detent of a lock extending from the handle of the second shaft that extends towards the first shaft.

Further, to the extent consistent, any of the aspects described herein may be used in conjunction with any or all of the other aspects described herein.

BRIEF DESCRIPTION OF THE DRAWINGS

Various aspects of the present disclosure are described hereinbelow with reference to the drawings, which are incorporated in and constitute a part of this specification, wherein:

FIG. 1 is a side view of an electrosurgical forceps in accordance with the present disclosure in an open configuration and a pivoting handle in a straight configuration;

FIG. 2 is a side view of the electrosurgical forceps ofFIG. 1 in a closed configuration and the pivoting handle in the straight configuration;

FIG. 3 is an enlarged, exploded view of a hinge of the pivoting handle ofFIG. 1;

FIG. 4 is a side view of the electrosurgical forceps ofFIG. 1 with the pivoting handle in the straight configuration with tissue between the jaws members;

FIG. 5 is a side view of the electrosurgical forceps ofFIG. 4 with the pivoting handle in a pivoted configuration; and

FIG. 6 is a schematic illustration of a medical work station and operating console in accordance with the present disclosure.

DETAILED DESCRIPTION

Embodiments of the present disclosure are now described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term “clinician” refers to a doctor, a nurse, or any other care provider and may include support personnel. Throughout this description, the term “proximal” refers to the portion of the device or component thereof that is closest to the clinician and the term “distal” refers to the portion of the device or component thereof that is farthest from the clinician.

This disclosure relates generally to a jaw force control for a surgical instrument to limit closure force applied to tissue by jaws members of the surgical instrument. The jaw force control is positioned on one of the shafts of the surgical instrument and includes a resilient member (e.g., a torsion spring) between first and second segments of the shaft of the surgical instrument. As the shafts are moved towards one another, the jaw members are moved towards a closed position and may engage tissue disposed between the jaw members. As the jaw members continue to move towards one another, a closure force is required to compress the tissue disposed between the jaw members so that the jaw members continue to move towards one another. The jaw force control limits this closure force by pivoting the first segment of the shaft relative to the second segment of the shaft when the closure force reaches a predetermined limit. The resilient member is calibrated to maintain the first and second segments in an unpivoted or straight configuration when the closure force is below the predetermined limit and to apply the closure force limit to the first and second jaw members when the first and second segments are pivoted relative to one another. As described herein, the jaw force control is detailed with respect to an open electrosurgical forceps; however, it is contemplated that such a jaw force control may be used in conjunction with other surgical instruments such as a grasper, a dissector, etc.

Referring now toFIG. 1, an openelectrosurgical forceps10 is provided in accordance with the present disclosure and includes afirst shaft20 and asecond shaft40. Each of the first andsecond shafts20,40 has aproximal handle24,44 and adistal jaw member26,46, respectively.

With additional reference toFIG. 2, theshafts20,40 are pivotal relative to one another about apivot60 between an open configuration (FIG. 1) and a closed configuration (FIG. 2). For the purposes herein,forceps10 will be described generally. However, the various particular aspects of one envisioned forceps are detailed in U.S. Pat. No. 9,017,372, the entire contents of which are incorporated by reference herein.

Thepivot60 passes through theshafts20,40 between thehandles24,44 and thejaw members26,46. Thefirst shaft20 is in electrical communication with anelectrosurgical cable18 that connects thejaw member26 to a source of electrosurgical energy. Additionally or alternatively, thesecond shaft40 may be in electrical communication with the electrosurgical cable and connects thejaw member46 to the source of electrosurgical energy.

Thesecond shaft40 includes ajaw force control50 that limits the closure force between thejaw members26,46 as thejaw members26,46 are moved towards the closed configuration. Thejaw force control50 is disposed on thesecond shaft40 between thepivot60 and thehandle44. Thejaw force control50 includes aproximal segment52 and adistal segment56 that are pivotally coupled together by a shaft pivot or hinge54.

With reference toFIG. 3, thehinge54 includes a proximal orfirst flange122 that extends from theproximal segment52, a distal orsecond flange162 that extends from thedistal segment56, and acoupling assembly140. Thefirst flange122 defines anopening126 and aslot127 for receiving portions of thecoupling assembly140. Thesecond flange162 includes aboss164 and defines anopening166 that passes through theboss164. Theboss164 defines aslot167 that receives a portion of thecoupling assembly140. Theboss164 also defines apassage168 that is coaxial with theopening166 to receive a portion of thecoupling assembly140.

Thecoupling assembly140 includes afastener142, aresilient member150, and asecurement member158. Thefastener142 has ahead144, ashank146, and a threadedportion148. Theresilient member150 is in the form of a torsion spring with abody152 that is positioned about theshank146 of thefastener142 and includes afirst arm154 and asecond arm156 extending from thebody152.

Thefastener142 passes through theopenings126,166 of the first andsecond flanges122,162 to pivotally couple the proximal anddistal segments52,56 of thejaw force control50 together. Thefirst flange122 is positioned over theshank146 of thefastener142 with theopening126 of thefirst flange122 aligned with theopening166 of thesecond flange162. Thehead144 of thefastener142 is positioned against an outer surface of thefirst flange122 with theshank146 extending through theopening166 of thesecond flange162 such that theshank146 is disposed substantially within thepassage168 defined in theboss164. The threadedportion148 of thefastener142 extends from theshank146 through theopening166 of thesecond flange162 with thesecurement member158 positioned over the threadedportion148 to secure thefastener142 within theopenings126,166 of the first andsecond flanges122,162, respectively. Thesecurement member158 is tightened to secure thefastener142 within theopenings126,166 while allowing pivotal movement between the first andsecond flanges122,162 of the first andsecond segments52,56, respectively.

Theresilient member150 is disposed over theshank146 with thebody152 of theresilient member150 disposed substantially within thepassage168 of theboss164. Thefirst arm154 of theresilient member150 is received in theslot127 of thefirst flange122 and thesecond arm156 of theresilient member150 is received in theslot167 of thesecond flange162. The first andsecond arms154,156 of theresilient member150 engage walls defining theslots127,167 of the first andsecond segments52,56, respectively, to bias the first andsecond segments52,56 towards the straight configuration. In the straight configuration, a longitudinal axis of thefirst segment52 substantially aligns with a longitudinal axis of thesecond segment56. The first andsecond flanges122,162 are shaped to prevent the first andsecond segments52,56 from over extending beyond an aligned or straight configuration (i.e., the first andsecond flanges122,162 form a mechanical stop).

With additional reference toFIGS. 4 and 5, theresilient member150 is configured to limit the closure force of thejaw members26,46 as thehandles24,44 are moved toward the closed configuration. Theresilient member150 is sized such that theresilient member150 prevents thejaws members26,46 from applying a pressure greater than a predetermined pressure limit to tissue disposed between thejaw members26,46. As shown inFIG. 4, theresilient member150 urges the proximal anddistal segments52,56 towards a straight configuration. As thehandles24,44 are moved toward one another with thick or uncompressible tissue disposed between thejaw members26,46, the closure force required to move thejaw members26,46 towards the closed configuration exceeds a predetermined closure force limit such that the bias of theresilient member150 is overcome. When the bias of theresilient member150 is overcome, theproximal segment52 pivots relative to thedistal segment56 to pivot towards a pivoted configuration as shown inFIG. 5. In the pivoted configuration, the longitudinal axis of the first segment defines a nonzero angle with the longitudinal axis of the second segment. The pivoting of theproximal segment52 relative to thedistal segment56 prevents thejaw members26,46 from exceeding the predetermined closure force and thus, from applying pressure greater than the predetermined pressure limit to tissue disposed between thejaw members26,46. In addition, the bias of theresilient member150 provides consistent pressure to tissue disposed between thejaw members26,46 when thesecond shaft40 is in the pivoted configuration.

The pivoting of theproximal segment52 provides visual and tactile feedback to a clinician that pressure applied to tissue between thejaw members26,46 is appropriate for application of electrosurgical energy such that theelectrosurgical forceps10 is in an activatable configuration. Theresilient member150 may have a constant spring rate or a progressive spring rate based on angular deflection of theresilient member150. When theresilient member150 has a constant spring rate, the spring rate of theresilient member150 is sufficient to provide a closure force to thejaw members26,46 within the predetermined limit of closure force to provide constant pressure suitable for application of electrosurgical energy to tissue. When theresilient member150 has a progressive spring rate, theproximal segment122 remains in the straight configuration when the closure force applied to thejaw members26,46 is below a threshold closure force and pivots towards the pivoted configuration when the closure force is greater than the threshold closure force. The threshold closure force is equal to a minimum pressure applied to tissue that is suitable for application of electrosurgical energy to tissue with thejaw members26,46. The progressive spring rate of theresilient member150 has a maximum closure force substantially equal to a force required to reach the predetermined limit of closure force as detailed above.

Referring toFIGS. 4 and 5, as thehandles24,44 are moved towards each other, the first andsecond shafts20,40 pivot about thepivot60 such that thejaw members26,46 move towards the closed configuration. As thejaw members26,46 move towards the closed configuration with a small vessel, or amount of tissue, or a large compressible vessel, or amount of tissue, positioned between thejaw members26,46, the closure force of thejaw members26,46 applies pressure to the vessel, or tissue until the vessel is compressed between thejaw members26,46. If the closure force required to move thejaw members26,46 towards the closed configuration is less than or equal to a suitable pressure for application of electrosurgical energy, thejaw members26,46 move towards the closed configuration effecting compression of the vessel, or tissue, until thehandles24,44 are in an approximated or closed position and thejaw members26,46 are in an activatable configuration as shown inFIG. 2. In the activatable configuration, the pressure between thejaw members26,46 is suitable for application of electrosurgical energy to the vessel, or tissue, between thejaw members26,46. If the closure force required to move thejaw members26,46 towards the closed configuration would result in pressure suitable for application of electrosurgical energy, thefirst segment52 of thesecond shaft40 pivots relative to thesecond segment56 of thesecond shaft40 such that thesecond shaft40 is in the pivoted configuration with thejaw members26,46 in an activatable configuration as shown inFIG. 5. In such an activatable configuration, the closure force applied to thejaw members26,46 is within the predetermined closure force limit such that thejaw members26,46 apply pressure for application of electrosurgical energy to the vessel, or tissue, between thejaw member26,46.

With particular reference toFIGS. 4 and 5, thefirst shaft20 may include astop72 that extends towards thesecond shaft40 from an inner surface of thehandle24. Thestop72 prevents over rotation or pivoting of thefirst segment52 relative to thesecond segment56. Specifically, as thefirst segment52 is pivoted relative to thesecond segment56, thehandle44 abuts thestop72 to limit pivoting of thefirst segment52 relative to thesecond segment56.

Thesecond shaft40 may includelock74 that extends from an inner surface of thehandle44 towards thefirst shaft20. Thelock74 includes a hook ordetent76 and thestop72 defines one ormore openings78. As shown inFIG. 5, thedetent76 engages theopening78 of thestop72 to prevent thefirst segment52 of thesecond shaft40 from moving away from thefirst shaft20 such that thefirst segment52 is maintained in position relative to thefirst shaft20. In such a configuration, theresilient member150 may provide a closure force to thejaw members26,46 such that thejaw members26,46 apply pressure to tissue that is suitable for application of electrosurgical energy.

The various embodiments disclosed herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery.” Such systems employ various robotic elements to assist the surgeon and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the surgeon during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.

The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another surgeon (or group of surgeons) remotely control the instruments via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.

The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).

The master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the surgeon's ability to mimic actual operating conditions.

Referring also toFIG. 6, a medical work station is shown generally aswork station1000 and generally may include a plurality ofrobot arms1002,1003; acontrol device1004; and anoperating console1005 coupled with thecontrol device1004. Theoperating console1005 may include adisplay device1006, which may be set up in particular to display three-dimensional images; andmanual input devices1007,1008, by means of which a person (not shown), for example a clinician, may be able to telemanipulate therobot arms1002,1003 in a first operating mode.

Each of therobot arms1002,1003 may include a plurality of members, which are connected through joints, and an attachingdevice1009,1011, to which may be attached, for example, a surgical tool “ST” supporting an end effector1100 (e.g., a pair of jaw members), in accordance with any one of several embodiments disclosed herein, as will be described in greater detail below.

Therobot arms1002,1003 may be driven by electric drives (not shown) that are connected to thecontrol device1004. The control device1004 (e.g., a computer) may be set up to activate the drives, in particular by means of a computer program, in such a way that therobot arms1002,1003, their attachingdevices1009,1011 and thus the surgical tool (including the end effector1100) execute a desired movement according to a movement defined by means of themanual input devices1007,1008. Thecontrol device1004 may also be set up in such a way that it regulates the movement of therobot arms1002,1003 and/or of the drives.

Themedical work station1000 may be configured for use on a patient “P” lying on a patient table1012 to be treated in a minimally invasive manner by means of theend effector1100. Themedical work station1000 may also include more than tworobot arms1002,1003, the additional robot arms likewise connected to thecontrol device1004 and telemanipulatable by means of theoperating console1005. A medical instrument or surgical tool (including an end effector1100) may also be attached to the additional robot arm. Themedical work station1000 may include adatabase1014 coupled with thecontrol device1004. In some embodiments, pre-operative data from patient/living being “P” and/or anatomical atlases may be stored in thedatabase1014.

While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Any combination of the above embodiments is also envisioned and is within the scope of the appended claims. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope of the claims appended hereto.

Claims (18)

What is claimed:

1. A surgical instrument, comprising:

a first shaft defining a first longitudinal shaft axis and having a proximal handle and a distal jaw member, the proximal handle defining a first opening and a second opening, the first and second openings spaced from one another in a direction parallel to the first longitudinal shaft axis;

a second shaft having a first segment and a second segment, the first segment including a proximal handle of the second shaft and the second segment including a distal jaw member of the second shaft, at least one of the first and second shafts pivotal relative to the other to pivot the jaw members between an open configuration wherein the jaw members are spaced relative to one another and an activatable configuration wherein the jaw members are closer to one another and suitable for applying electrosurgical energy to tissue disposed therebetween;

a hinge coupling the first segment of the second shaft to the second segment of the second shaft, the first and second segments having a straight configuration wherein the first and second segments align with a second longitudinal shaft axis defined through the second shaft and a pivoted configuration wherein the first segment is disposed at an angle relative to the second longitudinal shaft axis; and

a lock extending from an inner surface of the handle of the second shaft towards the handle of the first shaft, the lock including a detent configured to be disposed within the first or second opening to prevent the second shaft from pivoting towards the open configuration.

2. The surgical instrument according toclaim 1, wherein the hinge biases the first and second segments towards the straight configuration.

3. The surgical instrument according toclaim 1, wherein the first segment pivots relative to the second segment when a closure force of the jaw members exceeds a threshold closure force.

4. The surgical instrument according toclaim 3, wherein the threshold closure force is equal to a predetermined closure force limit.

5. The surgical instrument according toclaim 3, wherein the threshold closure force is less than a predetermined closure force limit.

6. The surgical instrument according toclaim 1, wherein the hinge includes a fastener, wherein the first segment includes a distally extending first flange defining a first opening disposed over the fastener, and wherein the second segment includes a proximally extending second flange defining a second opening disposed over the fastener.

7. The surgical instrument according toclaim 6, wherein the hinge includes a resilient member disposed about the fastener between the first and second flanges.

8. The surgical instrument according toclaim 7, wherein the resilient member is a torsion spring.

9. The surgical instrument according toclaim 7, wherein the resilient member has a constant spring rate.

10. The surgical instrument according toclaim 7, wherein the resilient member has a progressive spring rate.

11. The surgical instrument according toclaim 7, wherein the first and second flanges each define a slot that receive a respective arm of the resilient member.

12. The surgical instrument according toclaim 7, wherein the second flange defines a boss that extends towards the first flange, the boss defining a passage coaxial with the second opening and having a diameter larger than the second opening.

13. The surgical instrument according toclaim 12, wherein a body of the resilient member is received within the passage of the boss.

14. The surgical instrument according toclaim 1, wherein the first shaft includes a stop extending from an inner surface of the handle of the first shaft towards the handle of the second shaft, the stop configured to prevent the second shaft from pivoting beyond a closed configuration.

15. The surgical instrument according toclaim 14, wherein the first and second openings are defined in the stop.

16. A method of limiting closure force while grasping tissue with a surgical instrument, the method comprising:

positioning tissue between jaw members of the surgical instrument;

moving handles of first and second shafts of the surgical instrument towards one another to pivot the jaw members towards a closed configuration to apply pressure to tissue disposed between the jaw members;

limiting the pressure to a predetermined pressure limit by allowing a first segment of the second shaft to pivot about a common hinge relative to a second segment of the second shaft if the closure pressure exceeds the predetermined pressure limit; and

locking the surgical instrument in the closed configuration by engaging a first opening or a second opening defined in the first shaft with a detent of a lock extending from the second handle towards the first handle, the first and second openings spaced apart from one another in a direction parallel to a first longitudinal shaft axis defined by the first shaft.

17. The method according toclaim 16, further comprising delivering electrosurgical energy with the jaw members to the tissue between the jaw members when the first segment is pivoted relative to the second segment.

18. The method according toclaim 16, further comprising abutting a stop of the first shaft with the handle of the second shaft.

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